Studied by 2 peopleflail chest
fracture of two or more adjacent ribs in two or more places that allows for free movement of the fractured segment
paradoxal motion
movement of ribs in a flail segment that is opposite to the direction movement of the rest of the chest cavity
compression injuries develop from severe blunt trauma in which the chest is rapidly compressed, such as when
a driver strikes his chest on the steering column or when a person is trapped in a trench-wall collapse
flail chest occurs when blunt trauma creates a fracture of
two or more ribs in two or more places
sucking chest wound
an open chest wound in which is “sucked” into the chest cavity
watch the pt’s respiratory rate and depth. if respirations become too shallow,
assist ventilations
seal the open chest wound as quickly as possible. if need be, use your
gloved hand. do not delay sealing the wound to find an occlusive dressing
the danger of a pneumothorax and tension pneumothorax is the reason medical authorities
recommend the flutter valve (three sided) occlusive dressing instead of an occlusive dressing sealed on all four sides
you may have to maintain hand pressure over the occlusive dressing en route to the hospital. the tape also may not stick well to
bloody skin or to skin that is sweaty from shock
foil edges may lacerate the pt’s skin and may
tear when lifted to release pressure
the chest can hold more than
3L of blood
pneumothorax
air in the chest cavity
tension pneumothorax
type of pneumothorax in which air that enters the chest cavity is prevented from escaping
what can shift to the opposite side and is a very late sign and difficult to detect
the trachea
traumatic asphyxia
associated with sudden compressions of the chest. when this occurs the sternum and the ribs exert severe pressure on the heart ad lungs, forcing blood out of the right atrium and up into the jugular veins in the neck
cardiac tamponade
when an injury to the heart causes blood to flow into the surrounding pericardial sac
the aorta can be damaged without
trauma
degeneration of the aorta, often worsened by high blood pressure or other diseases, causing
weakening of this large vessel
aortic dissection Is a condition where the inner layer of the wall of the aorta
begins to tear
blood from the interior of the vessel leaks into the outer layers and eventually causes
a balloon-like profusion, called an aneurysm
the pt may have differences in pulse or blood pressure between the right and left arms or differences in pulses between the
arms and the legs or the legs themselves (in abdominal aortic injury)
commotion cordis uncommon condition that is easy to recognize and treat. when somebody gets hit in the center of the chest, the result is
usually a bruise or even perhaps a fracture.
in commotion cordis , how ever, the impact occurs just when the heart is
vulnerable
there are several hundredths of a second during each heart beat when the heart, if sufficiently stimulated, will go
inro ventricular fibrillation (VFIB)
an examine of this is a young athlete who tries to catch a baseball but misses. the ball strikes him
in the center of the chest and the pt collapses in cardiac arrest
evisceration
an intestine or other internal organ protruding through a wound in the abdomen
the liver is very vascular; therefore, when it is injured, it can bleed
profusely, often to the point of life-threatening blood loss
hollow organs in the abdomen include
stomach, small and large bowels, gallbladder, and urinary bladder
if these organs are injured, they often spill their contents into the
abdominal cavity, leading to severe irritation and often peritonitis
for abdominal injuries
control external bleeding and stress all open wounds, do not touch or try to replace any eviscerated, or exposed, organs apply a sterile dressing moistened with sterile saline over the wound site
Note
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